ByScott BaldaufStaff Writera CorrespondentDecember 12, 2008

Desperation: In Harare, a boy prepares to drink clean water from a borehole Dec. 11. On Thursday, the UN raised the Cholera death toll to 783. Zimbabwe's crisis is putting pressure on neighbors who have been hesitant to intervene in the struggling country's affairs.

JOHANNESBURG, South Africa and HARARE, Zimbabwe — Few calamities signal a society under stress like an outbreak of cholera. So when Zimbabwe reported cases of cholera – a disease that spreads when raw sewage enters the drinking water supply – it was an admission that the country and its government had ceased to function effectively.

"Cholera occurs when there is a breakdown in the working system of sanitation, one of the basic functions of a government," says Ozias Tungwarara, a senior researcher at the Open Society Institute in Johannesburg. "That is a signal that the government has failed, failed to take care of its responsibilities to protect citizens."

As Zimbabweans flee their country, and its overstretched hospitals, the epidemic has now spread to neighboring states. This week, the South African government declared the border area with Zimbabwe to be a disaster area. Zambia, Botswana, and Mozambique too have seen cholera cases increase in recent weeks.

Combined with chronic malnutrition, rampant inflation, a cash shortage, and now-constant strikes by unpaid workers – including riots by Army soldiers – Zimbabwe's bout with cholera puts increased pressure on neighboring countries to act, if only to protect the health of their own citizens. To date, Zimbabwe's neighbors have been reluctant to intervene in Zimbabwe's affairs, pleading for the on-again, off-again power-sharing agreement between Zimbabwe's two rival parties to take effect. But with a UN-estimated 783 deaths and 16,000 infections, time and patience seems to be running out.

University of Zimbabwe political science lecturer Simon Badza says the outbreak of cholera in Zimbabwe – and the spread of the preventable and easily treated disease to neighboring countries – has the potential to destabilize the whole southern region of Africa. "So pressure is mounting on the Zimbabwe government to address the crisis," says Mr. Badza. "It is both local, regional, and international pressure."

With its weak economy, lack of doctors and nurses, and lack of medicines, Zimbabwe needs international help to contain the cholera – a move made difficult by Zimbabwe's poor relations with donor nations, its rough human rights record toward its citizens, and its refusal to honor past political agreements and treaties.

Zimbabwe has one of the highest unemployment rates in the world, more than 80 percent, and economists estimate its inflation rate to be an astronomical 280 million percent per year. Low farm production on once highly productive farms means that Zimbabwe relies almost entirely on foreign aid and cash remittances sent home by Zimbabweans living abroad.

The Zimbabwe health ministry's answer to the cholera outbreak was to shut off the public water supply in Harare, since it did not have the foreign currency to buy chemicals to ensure that the water supply was clean. Aid groups such as World Vision and Oxfam, and UN agencies such as UNICEF have taken up some of the slack by distributing food and water purification tablets, but these are stop-gap measures at best.

"With close to half the population weakened by serious food shortages, cholera, when it hits, is even more likely to be lethal," said Peter Mutoredzanwa, Country Director for Oxfam in Zimbabwe in a recent statement. "Indications are that more than 5 million people will urgently need food aid by January."

Noting President Robert Mugabe's statement on national TV this week that the cholera epidemic was under control, Badza says the government is in denial, and appears more concerned about the political crisis with its rivals, the Movement for Democratic Change (MDC), which defeated Mugabe's party in the first round of elections on March 29. A power-sharing agreement with MDC leader Morgan Tsvangirai, signed in September, has still not taken effect, as Mugabe and Prime-Minister elect Tsvangirai bicker over cabinet ministry appointments. Mr. Mugabe has insisted on holding onto all key security and financial ministries.

"When threats to State security abundantly increase, normally the human security is relegated and compromised," says Badza. "I consider the cholera to be [an equally important issue] of human security."